MedWorm: Aspergillosis

Factors associated with a shorter time until the next pulmonary exacerbation in adult patients with cystic fibrosis.

Chronic Respiratory Disease — Wed, 08 Feb 2012 09:06:02 +0100

Authors: Sequeiros IM, Jarad N Abstract Time until the subsequent exacerbation (PEx) in cystic fibrosis (CF) is a significant health outcome and one of the significant end points in clinical trials. Risk factors associated with shorter time until the next exacerbation (TUNE) have not been reported. This is a prospective study. TUNE was the number of days from the end of intravenous (IV) antibiotic treatment of a PEx until the day of start of IV antibiotics for the following PEx. Factors assessed were age, gender, site of treatment, CF-related diabetes (CFRD), allergic bronchopulmonary aspergillosis (ABPA) and infection with Pseudomonas aeruginosa (PA). In addition, we examined parameters obtained at day 14 of treatment including forced expiratory volume in the first second (FEV1), ...

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Fluticasone propionate: Allergic bronchopulmonary aspergillosis: case report

Reactions — Sun, 05 Feb 2012 18:29:54 +0100

(Source: Reactions)

Orbital Aspergillosis: Voriconazole – The New Standard Treatment?

Karger Publishers — Fri, 03 Feb 2012 23:00:00 +0100

Case Rep Ophthalmol 2012;3:46–53 (DOI:10.1159/000336276) (Source: Karger Publishers)

Fungi and allergic lower respiratory tract diseases

Journal of Allergy and Clinical Immunology — Wed, 01 Feb 2012 05:00:00 +0100

Asthma is a common disorder that in 2009 afflicted 8.2% of adults and children, 24.6 million persons, in the United States. In patients with moderate and severe persistent asthma, there is significantly increased morbidity, use of health care support, and health care costs. Epidemiologic studies in the United States and Europe have associated mold sensitivity, particularly to Alternaria alternata and Cladosporium herbarum, with the development, persistence, and severity of asthma. In addition, sensitivity to Aspergillus fumigatus has been associated with severe persistent asthma in adults. Allergic bronchopulmonary aspergillosis (ABPA) is caused by A fumigatus and is characterized by exacerbations of asthma, recurrent transient chest radiographic infiltrates, coughing up thick mucus plugs,...

Triple fungal infection in a patient with liver cirrhosis.

Annales de Biologie Clinique — Wed, 01 Feb 2012 05:00:00 +0100

We report a case of triple fungal infection including an invasive pulmonary aspergillosis by Aspergillus fumigatus, a candidemia by Candida albicans and a Pneumocystis pneumonia. The overall clinical picture of this patient was liver cirrhosis with medical history of immunosuppressive treatment for Crohn disease and a non-hodgkin lymphoma. There was no antifungal prophylaxis for this patient. Under treatment, the issue was unfavourable with multivisceral failure. PMID: 22294141 [PubMed - as supplied by publisher] (Source: Annales de Biologie Clinique)

Clotrimazole and enilconazole distribution within the frontal sinuses and nasal cavity of nine dogs with sinonasal aspergillosis

The Journal of Small Animal Practice — Wed, 01 Feb 2012 05:00:00 +0100

The objective of this study was to describe the distribution and retention of enilconazole and clotrimazole solutions using a temporary trephination protocol.Methods: Nine client‐owned dogs diagnosed with mycotic rhinosinusitis between March 2008 and December 2009 were prospectively enrolled and were sequentially allocated to receive treatment with either clotrimazole (1% in polyethylene glycol) or enilconazole (10% solution), after imaging and rhinoscopic assessment. Both frontal sinuses were trephined, debrided and flushed with saline. Infusion was administered via frontal sinuses with dogs in sternal recumbency and computed tomography (CT) performed 5 minutes after completion. Distribution was scored 1 to 4 at the canine tooth, premolar 4, cribriform plate and frontal sinus on both si...

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[Invasive aspergillosis after near-drowning: case reports and review of the literature]

The Aspergillus Website - articles — Mon, 30 Jan 2012 12:58:14 +0100

Li P, Cao EH, Zhao BL, Sun HM, Li MM, Xu J, Song Y, Shi Y (Source: The Aspergillus Website - articles)

Invasive Pulmonary Aspergillosis.

Australasian Medical Journal - AMJ — Mon, 30 Jan 2012 04:17:05 +0100

(Source: Australasian Medical Journal - AMJ)

[Invasive aspergillosis of the maxillary sinus in an immunocompetent patient.]

Revue de Stomatologie et de Chirurgie Maxillo-Faciale — Fri, 27 Jan 2012 05:00:00 +0100

We report a pseudo-tumoral presentation of invasive aspergillosis of the maxillary sinus, in immunocompetent adult. CASE REPORT: A 70-year-old female patient consulted for chronic rhino-sinusitis resistant to medical treatment. Computed tomography scan revealed a hyperdense mass filling the left maxillary antrum, with erosion of sinus walls. The ethmoidal and right frontal sinuses were involved. The histological and mycological examination of the surgical resection confirmed the diagnosis of invasive aspergillosis. The patient was given voriconazole as first line treatment. The outcome was good at 18 months. DISCUSSION: Invasive aspergillosis of the maxillary sinus is a rare disease, usually observed in immunodepressed patients. It is very rarely observed in immunocompetent patients. P...

TLR3 essentially promotes protective class I-restricted memory CD8+ T-cell responses to Aspergillus fumigatus in hematopoietic transplanted patients

Blood — Thu, 26 Jan 2012 05:00:00 +0100

Aspergillus fumigatus is a model fungal pathogen and a common cause of severe infections and diseases. CD8+ T cells are present in the human and murine T-cell repertoire to the fungus. However, CD8+ T-cell function in infection and the molecular mechanisms that control their priming and differentiation into effector and memory cells in vivo remain elusive. In the present study, we report that both CD4+ and CD8+ T cells mediate protective memory responses to the fungus contingent on the nature of the fungal vaccine. Mechanistically, class I MHC-restricted, CD8+ memory T cells were activated through TLR3 sensing of fungal RNA by cross-presenting dendritic cells. Genetic deficiency of TLR3 was associated with susceptibility to aspergillosis and concomitant failure to activate memory-protectiv...

Post‐diagnostic Kinetics of the (1→3)‐β‐D‐Glucan Assay in Invasive Aspergillosis, Invasive Candidiasis, and Pneumocystis jirovecii Pneumonia

Clinical Microbiology and Infection — Mon, 23 Jan 2012 05:00:00 +0100

Abstract:The kinetics of serum (1→3)‐β‐D‐glucan (BG) following the diagnosis of invasive fungal disease and administration of antifungal therapy are poorly characterized. It is unknown whether early BG changes have prognostic implications. We assessed the post‐diagnostic kinetics of BG in patients with an initial serum BG ≥80 pg/mL and at least one additional post‐diagnostic BG value in the setting of invasive aspergillosis (IA, n=69), invasive candidiasis (IC, n=40), or Pneumocystis jirovecii pneumonia (PCP, n=18), treated with antifungal therapy. Clinical failure of antifungal therapy and mortality were assessed at 6 and 12 weeks, and Cox modeling was used to assess the hazard of initial BG and change in BG at 1 or 2 weeks for these outcomes. In patients with ≥2 BG value...

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Spectrum of fungal infection in a neurology tertiary care center in India

Neurological Sciences — Thu, 19 Jan 2012 06:56:24 +0100

This study reports clinical, MRI and outcome of patients with central nervous system (CNS) fungal infections. 39 patients with CNS fungal infections treated in neurology service during the last 3 years were included and a detailed medical history and clinical examination were undertaken. Cranial MRI including paranasal sinuses were carried out and the location and nature of abnormalities were noted. Fungal infection was confirmed by CSF examination or histopathology. Death during hospital stay was noted. The median age was 37 (8–72) years and 8 were females. The clinical features included altered sensorium in 31, focal motor deficits in 13, visual loss in 12, seizures in 10, diplopia in 7, and papilledema in 9 patients. 28 patients had the following predisposing condition...

Bronchiectasis in a Diverse U.S. Population: Effects of Ethnicity on Etiology and Sputum Culture.

Chest — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSIONS:The etiology of bronchiectasis can be determined in the majority of patients in a heterogeneous U.S. population and is most often due to immune dysregulation. Rheumatoid arthritis is more likely in AA patients compared to EA patients. HA patients are more likely to have P. aeruginosa in their sputum. PMID: 22267679 [PubMed - as supplied by publisher] (Source: Chest)

Immunoproteomics based identification of thioredoxin reductase GliT and novel Aspergillus fumigatus antigens for serologic diagnosis of invasive aspergillosis

BMC Microbiology - Latest articles — Wed, 18 Jan 2012 05:00:00 +0100

Conclusions: The immunoreactive proteins identified in this study may be helpful for the diagnosis of IA in critically ill patients. Our results indicate that TR and other immunodominant antigens have potential as biomarkers for the serologic diagnosis of invasive aspergillosis. (Source: BMC Microbiology - Latest articles)

A Case of Endobronchial Aspergilloma Presenting as a Broncholith.

The American Journal of the Medical Sciences — Wed, 18 Jan 2012 05:00:00 +0100

Authors: Yeo CD, Baeg MK, Kim JW Abstract A 75-year-old woman with no history of pulmonary disease was admitted to the hospital complaining of fever and chills. Chest computed tomography and bronchoscopy suggested a broncholith-like calcified endobronchial lesion and postobstructive pneumopathy in the left lower bronchus. The mass obstructing the airway was removed using grasping forceps and it was diagnosed pathologically as endobronchial aspergillosis. Endobronchial aspergilloma presenting radiographically as a calcification without adjacent calcified lymph nodes is a rare condition, even though pulmonary fungal diseases including endobronchial actinomycosis can mimic broncholithiasis. PMID: 22261627 [PubMed - as supplied by publisher] (Source: The American Journal of the Med...

Prednisone/sirolimus/tacrolimus: Aspergillosis in an elderly patient: case report

Reactions — Tue, 17 Jan 2012 19:08:18 +0100

(Source: Reactions)

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Enteral voriconazole induced hypoglycemia: A potentially life threatening complication

Indian Journal of Pharmacology — Sat, 14 Jan 2012 05:00:00 +0100

Tanmoy Ghatak, Ratender Kumar Singh, Arvind Kumar BaroniaIndian Journal of Pharmacology 2012 44(1):138-139Voriconazole is a newer effective antifungal agent currently available for the treatment of invasive aspergillosis. The case we present describes an episode of serious persistent hypoglycemia after voriconazole therapy and we believe that this strongly contributed to this event. It is a warning to all that voriconazole has a propensity to alter glucose homeostasis in the presence of kidney disturbance. (Source: Indian Journal of Pharmacology)

Sensitization to Aspergillus antigens and occurrence of allergic bronchopulmonary aspergillosis in patients with asthma

The Aspergillus Website - articles — Fri, 13 Jan 2012 21:03:29 +0100

Maurya V, Gugnani HC, Sarma PU, Madan T, Shah A (Source: The Aspergillus Website - articles)

Concurrent allergic bronchopulmonary aspergillosis and aspergilloma: is it a more severe form of the disease?

The Aspergillus Website - articles — Fri, 13 Jan 2012 20:49:47 +0100

Shah A (Source: The Aspergillus Website - articles)

Frequency of familial occurrence in 164 patients with allergic bronchopulmonary aspergillosis

The Aspergillus Website - articles — Fri, 13 Jan 2012 20:47:45 +0100

Shah A, Kala J, Sahay S, Panjabi C (Source: The Aspergillus Website - articles)

Concomitant allergic bronchopulmonary aspergillosis and allergic Aspergillus sinusitis: a review of an uncommon association*

The Aspergillus Website - articles — Fri, 13 Jan 2012 20:45:58 +0100

Shah A, Panchal N, Agarwal AK (Source: The Aspergillus Website - articles)

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Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis

The Aspergillus Website - articles — Fri, 13 Jan 2012 17:53:39 +0100

David W Denning, Alex Pleuvry & Donald C Cole (Source: The Aspergillus Website - articles)

Fatal subarachnoid hemorrhage caused by Aspergillus arteritis without angiographic abnormalities

Neuropathology — Thu, 12 Jan 2012 05:00:00 +0100

We describe a case of fatal SAH caused by Aspergillus arteritis without formation of fusiform dilatation or aneurysms. A 76‐year‐old man with a 2‐month history of progressive visual loss due to pachymeningitis around the optic nerves suffered from SAH in the bilateral sylvian fissures. Repetitive serum galactomannan assay and angiography showed no abnormality. Post mortem examination revealed marked proliferation of Aspergillus in the granulomas of the frontal base dura mater. In addition, major trunks and several branches of the bilateral middle cerebral arteries were invaded by Aspergillus hyphae, which destroyed the walls in the absence of dilatation and aneurysms. Invasive aspergillosis of the CNS often forms a mycotic aneurysm. However, four autopsy cases of nonaneurysmal SAH du...

Isolation of multiple-triazole-resistant Aspergillus fumigatus strains carrying the TR/L98H mutations in the cyp51A gene in India

Journal of Antimicrobial Chemotherapy — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions We report for the first time from India the occurrence of TR/L98H mutations in the cyp51A gene (responsible for reduced azole susceptibility) in two A. fumigatus isolates from patients with chronic respiratory disease who had not previously been exposed to azoles. The presence of TR/L98H is consistent with a route of resistance development through exposure to azole compounds in the environment. Given the emergence of azole resistance in environmental strains, continued surveillance of resistance in clinical A. fumigatus strains is desirable for successful therapy of aspergillosis. (Source: Journal of Antimicrobial Chemotherapy)

Biomedically important pathogenic fungi detection with volatile biomarkers

Journal of Breath Research — Tue, 10 Jan 2012 05:00:00 +0100

Volatile chemical profiles collected from the headspace of Aspergillus fumigatus (a pathogenic fungus that causes invasive pulmonary aspergillosis, allergic bronchopulmonary aspergillosis and chronic fungal sinusitis) grown on media with the connective tissue protein elastin, found in lung tissue, contained a large abundance of the sesquiterpene farnesene (3,7,11-trimethyl-1,3,6,10-dodecatetraene) and, depending on extraction time and sorbent material, other farnesene isomers and sesquiterpenes such as bisabolene (methyl-4-(6-methylhepta-1,5-dien-2-yl)cyclohex-1-ene). When human lung cells were cultured externally and infected with A. fumigatus , farnesene was also detected in each model lung system. Volatiles measured from cultured nasal lavage collected from a patient diagnosed w...

Mannose‐binding lectin genotype and serum levels in patients with chronic and allergic pulmonary aspergillosis

International Journal of Immunogenetics — Mon, 09 Jan 2012 17:56:49 +0100

SummarySeveral studies suggest mannose‐binding lectin (MBL) deficiency is associated with various manifestations of aspergillosis. MBL serum levels and function are genetically determined, but levels rise during inflammation. We address the relative frequency of deficient genotypes, the relationship between serum level and genotype and both age and disease manifestations in patients with chronic pulmonary (CPA) and allergic bronchopulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS). DNA was extracted from blood samples, and MBL2 genotyping was performed using the INNO‐LiPA MBL2 kit. Serum MBL concentrations were determined using ELISA. One hundred and eight patients were evaluated, 70 (65%) with CPA, 38 (35%) with allergic disease (ABPA, SAFS or undefined)...

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Deciphering cell wall integrity signalling in Aspergillus fumigatus: identification and functional characterization of cell wall stress sensors and relevant Rho GTPases

Molecular Microbiology — Wed, 04 Jan 2012 05:00:00 +0100

SummaryThe fungal cell wall, a conserved and highly dynamic structure, is essential for virulence and viability of fungal pathogens and is an important antifungal drug target. The cell wall integrity (CWI) signalling pathway regulates shape and biosynthesis of the cell wall. In this work we identified, localized and functionally characterized four putative CWI stress sensors of Aspergillus fumigatus, an airborne opportunistic human pathogen and the cause of invasive aspergillosis. We show that Wsc1 is specifically required for resistance to echinocandin antifungals. MidA is specifically required for elevated temperature tolerance and resistance to the cell wall perturbing agents congo red and calcofluor white. Wsc1, Wsc3 and MidA additionally have overlapping functions and are redundantly ...

Real-time nucleic Acid sequence-based amplification to predict the clinical outcome of invasive aspergillosis.

J Korean Med Sci — Sun, 01 Jan 2012 05:00:00 +0100

This study suggests that the serial monitoring of RTi-NASBA could be useful for prediction of the clinical outcome in hematologic patients with IA. PMID: 22219607 [PubMed - in process] (Source: J Korean Med Sci)

Distribution and persistence of topical clotrimazole after sinus infusion in normal canine cadavers

The Journal of Small Animal Practice — Sun, 01 Jan 2012 05:00:00 +0100

Objectives: To determine the in vitro persistence of clotrimazole 1% cream in the canine frontal sinus and to evaluate the distribution of clotrimazole solution over the sino‐nasal mucosa using a previously described surgical treatment protocol for canine nasal aspergillosis.Methods: Two canine skulls were used to monitor the persistence of clotrimazole cream in the lateral frontal sinus at 37°C. The distribution of irrigation solution around the frontal sinus compartments and nasal cavity was determined using six canine cadaver heads by trephining either the lateral or both the lateral and rostral compartments of the frontal sinus. Stain was added to the sinus irrigation solution before visually inspecting the sagittally sectioned heads.Results: Clotrimazole cream persisted in the fron...

A systematic review of validated methods for identifying infection related to blood products, tissue grafts, or organ transplants using administrative data

Pharmacoepidemiology and Drug Safety — Sun, 01 Jan 2012 05:00:00 +0100

ConclusionsThere is little evidence to support the validity of algorithms to identify infections related to blood products, tissue grafts, or organ transplants in administrative data or algorithms to identify the exposures. Although it may be possible to validate algorithms to identify the exposures and infectious outcomes, the use of administrative data to identify infections transmitted by these exposures may be challenging. Codes indicating infections acquired through medical care may be useful. Copyright © 2012 John Wiley & Sons, Ltd. (Source: Pharmacoepidemiology and Drug Safety)

The effects of the Influence of pretreating serum samples on the performance of a latex agglutination test for serodiagnosis of paracoccidioidomycosis.

Clinical and Vaccine Immunology — Wed, 28 Dec 2011 05:00:00 +0100

In this study, we did not observe cross-reactivity with histoplasmosis, but some reactions to aspergillosis and bacterial infections were noted. Normal human sera were not reactive in our tests. These results indicate the need for the elimination of heterologous reactions so that we can adequately use this method for screening cases of PCM. PMID: 22205661 [PubMed - as supplied by publisher] (Source: Clinical and Vaccine Immunology)

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[Allergic bronchopulmonary aspergillosis mimicking lung cancer in patients without bronchial asthma - case report.]

Pneumonologia i Alergologia Polska — Mon, 26 Dec 2011 23:30:40 +0100

Authors: Nowicka U, Wiatr E, Jakubowska L, Polubiec-Kownacka M Abstract Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder characterized by hypersensitivity reaction to Aspergillus, mainly Aspergillus fumigatus with variable radiological findings. The prevalence of ABPA is about 1-2% in patients with asthma and 5-15% in patients with cystic fibrosis. Very infrequently the disease is diagnosed in patients without previous bronchial asthma. The case of 45 year old women has been shown, who was admitted to the hospital with suspicious of lung cancer with hilar lymphadenopathy, without asthma. After examinations ABPA has been diagnosed. After treatment clinical, radiological, serological improvement were observed. Pneumonol. Alergol. Pol. 2011; 80, 1: 77-81. PM...

Pulmonary Artery Occlusion With Ethylene Vinyl Alcohol Copolymer in Patients With Hemoptysis: Initial Experience in 12 Cases

American Journal of Roentgenology — Thu, 22 Dec 2011 05:00:00 +0100

CONCLUSION. Ethylene vinyl alcohol copolymer embolization for hemoptysis of pulmonary arterial origin is feasible and efficacious. Use of this embolization agent is beneficial in patients with pulmonary artery injuries, especially those with small-necked lesions. (Source: American Journal of Roentgenology)

Evaluation of a Recombinant Antigen-Based EIA for the Diagnosis of Non-Invasive Aspergillosis

The Aspergillus Website - articles — Mon, 19 Dec 2011 15:40:00 +0100

Guitard J, Sendid B, Thorez S, Gits M, Hennequin C (Source: The Aspergillus Website - articles)

Impact of the revised (2008) EORTC/MSG definitions for invasive fungal disease on the rates of diagnosis of invasive aspergillosis

The Aspergillus Website - articles — Wed, 14 Dec 2011 18:17:01 +0100

Tsitsikas DA, Morin A, Araf S, Murtagh B, Johnson G, Vinnicombe S, Ellis S, Suaris T, Wilks M, Doffman S, Agrawal SG (Source: The Aspergillus Website - articles)

Diagnostic Accuracy of Serum 1,3-β-D-Glucan for Pneumocystis Jiroveci Pneumonia, Invasive Candidiasis and Invasive Aspergillosis: Systematic Review and Meta-Analysis

The Aspergillus Website - articles — Wed, 14 Dec 2011 18:15:10 +0100

Onishi A, Sugiyama D, Kogata Y, Saegusa J, Sugimoto T, Kawano S, Morinobu A, Nishimura K, Kumagai S (Source: The Aspergillus Website - articles)

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Two cases of endobronchial carcinoid masked by superimposed aspergillosis: a review of the literature of primary lung cancers associated with Aspergillus

The Aspergillus Website - articles — Wed, 14 Dec 2011 18:11:09 +0100

Nilsson JR, Restrepo CS, Jagirdar J (Source: The Aspergillus Website - articles)

Antifungal treatment affects the laboratory diagnosis of invasive aspergillosis

Journal of Clinical Pathology — Tue, 13 Dec 2011 05:00:00 +0100

Conclusions Previous exposure to antifungal therapy must be considered when interpreting either qPCR or galactomannan-based IA diagnostics as this study has shown that individual classes of antifungal agents impact upon the dynamics of antigen and DNA release into the circulation. (Source: Journal of Clinical Pathology)

Allergic Bronchopulmonary Aspergillosis and Related Allergic Syndromes

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 682-692DOI: 10.1055/s-0031-1295716ABSTRACTWhile allergic bronchopulmonary aspergillosis (ABPA) is well recognized as a fungal complication of asthma, severe asthma with fungal sensitization (SAFS) is not. In ABPA the total immunoglobulin E (IgE) is usually >1,000 IU/mL, whereas in SAFS it is <1,000 IU/mL, and either skin prick tests or fungus-specific IgE tests are positive. ABPA may present with any severity of asthma, and occasionally with no asthma or cystic fibrosis, the other common underlying disease. SAFS is a problem in patients with poorly controlled asthma and occasionally presents in the intensive care unit (ICU). Production of mucous plugs and coughing paroxysms is more common in ABPA. Certain underlying genetic defects seem to underpi...

Pulmonary Aspergillosis: Recent Advances

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 673-681DOI: 10.1055/s-0031-1295715ABSTRACTAspergillosis remains a significant cause of morbidity and mortality. The spectrum of disease is diverse and ranges from noninvasive disease with an excessive immune response, such as in allergic bronchopulmonary aspergillosis (ABPA), to a lack of an immune response as seen in patients with quantitative or qualitative granulocyte deficits and subsequent invasive pulmonary aspergillosis.Noninvasive diagnostic testing has improved the time to initiation of effective antifungal therapy, and numerous agents in different therapeutic classes are now available as treatment options. Voriconazole remains the preferred agent in the treatment of invasive pulmonary aspergillosis, and recent data have increased interest in t...

Pulmonary Mucormycosis

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 693-702DOI: 10.1055/s-0031-1295717ABSTRACTMucormycosis (formerly zygomycosis) is a life-threatening opportunistic mycosis that infects a broad range of hosts with qualitative or quantitative defects in innate immunity, including patients with severe neutropenia, recipients of corticosteroids or other immunosuppressive medications, poorly controlled diabetes mellitus, and those with iron overload states. Mucormycosis has recently emerged as breakthrough sinopulmonary infection in hematologic patients and recipients of transplantation being on antifungal prophylaxis with Aspergillus-active antifungals that lack activity against Mucorales. Unlike pulmonary aspergillosis, the prognosis and outcome of pulmonary mucormycosis have not improved significantly ov...

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Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosi

The Aspergillus Website - articles — Fri, 09 Dec 2011 19:29:02 +0100

David W Denning, Alex Pleuvry & Donald C Cole (Source: The Aspergillus Website - articles)

The role of combination antifungal therapy in the treatment of invasive aspergillosis: a systematic review

International Journal of Infectious Diseases — Mon, 05 Dec 2011 05:00:00 +0100

Conclusion: Cumulative evidence supporting the use of combination antifungal therapy in IA is conflicting and of moderate strength. Well-designed RCTs are required to adequately address the issue of the usefulness of this approach. (Source: International Journal of Infectious Diseases)

Invasive pulmonary aspergillosis in a patient with seminomatous testicular cancer

Mycoses — Thu, 01 Dec 2011 05:00:00 +0100

SummaryIn the past years there has been an increasing incidence of invasive fungal infections, particularly in immunocompromised patients. These infections continue to pose a diagnostic and therapeutic challenge. Considering these facts, the authors report a clinical case of invasive pulmonary aspergillosis which illustrates the improved outcomes associated with the extended‐spectrum triazole, voriconazole, used in first‐line therapy. (Source: Mycoses)

Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis.

Bulletin of the World Health Organization — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION: The global burden of CPA as a sequel to PTB is substantial and warrants further investigation. CPA could account for some cases of smear-negative PTB. Since CPA responds to long-term antifungal therapy, improved case detection should be urgently undertaken. PMID: 22271943 [PubMed - in process] (Source: Bulletin of the World Health Organization)

Invasive Myceliophthora thermophila infection mimicking invasive aspergillosis in a neutropenic patient: a new cause of cross-reactivity with the Aspergillus galactomannan serum antigen assay

The Aspergillus Website - articles — Fri, 25 Nov 2011 21:37:22 +0100

Morio F, Fraissinet F, Gastinne T, Le Pape P, Delaunay J, Sigler L, Gibas CF, Miegeville M (Source: The Aspergillus Website - articles)

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Unexpected Hyphal Strike: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

The risk of invasive aspergillosis (IA) in patients with haematological malignancies and following organ transplantation is well characterised; IA is a recognised complication of prolonged high dose corticosteroid therapy, cytotoxic therapy and severe neutropenia. However, new groups at risk of IA with minimal or no immunosuppression continue to emerge; critically-ill patients and post surgical patients are among this group. The important risk factors in these patients are less well defined. (Source: Journal of Infection)

A novel application of statistical process control charts - monitoring air quality in a paediatric haematology/oncology unit: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

This study sought to determine whether the same principles of process management were useful in environmental air monitoring of high risk healthcare units. Results of air sampling at several sites within the paediatric haematology/oncology/BMT unit (in addition to external sites within the hospital grounds) collected over a 2 year period were used to produce SPC charts. (Source: Journal of Infection)

Invasive Aspergillosis in a patient with Asthma post H1N1 PneumoniaD Nayar1, Cook P1, Lim L1, Allison D1, Denning D2County Durham and Darlington Foundation Trust1National Aspergillosis Centre, University Hospital of South Manchester2: Category: Clinical lesson

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

We present a case of IA in an atypical patient group - a patient with asthma admitted to our Intensive Care Unit with H1N1 pneumonia.We avoided steroids (this would almost certainly have resulted in her death without voriconazole), but she still got IA. (Source: Journal of Infection)

The effect of antifungal treatments on laboratory diagnostic assays for invasive fungal infections: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

Invasive aspergillosis (IA) remains a major concern in the management of patients undergoing haematopoietic stem cell transplantation. Due to the acknowledged risk of IA a number of strategies have been developed for the use of antifungal agents ranging from prophylaxis, via pre-emptive therapy to empiric therapy, however diagnosis of IA remains problematic with clinical symptoms that are often non-specific and some radiological findings, such as the presence of a halo sign or cavitating nodules in the lungs may being strongly suggestive of aspergillosis also associated with other infections. Diagnostic tests such as Galactomannan (GM) enzyme immunoassay and qPCR have been widely employed, but it is not clear how the different antifungal treatment strategies influence these tests. (Source:...

Invasive Pulmonary Aspergillosis

Australasian Medical Journal - AMJ — Fri, 25 Nov 2011 04:33:27 +0100

Aspergillus spp. often colonize the respiratory tract of the critically ill patients in the intensive care units and subsequently cause invasive disease. The risk of developing invasive disease is more in immunocompromised patients. Here we report a case of fatal invasive pulmonary aspergillosis caused by Aspergillus versicolor in a post-operative patient on mechanical ventilation, who did not respond to intravenous itraconazole. We have discussed the challenges involved in accurate diagnosis of this condition and appropriate management. (Source: Australasian Medical Journal - AMJ)

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Emergency versus elective living-donor liver transplantation: a comparison of a single center analysis

Surgery Today — Thu, 24 Nov 2011 17:49:42 +0100

Conclusion Careful perioperative management, including preoperative investigation of aspergillosis and empiric antibiotic therapy, should be considered for emergency LDLT patients who fulfill IPA risk factors. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00595-011-0040-5Authors Kazuhisa Takeda, Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 JapanKuniya Tanaka, Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 JapanTakafumi Kumamoto, Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, ...

Aspergillus versicolor, a New Causative Agent of Canine Disseminated Aspergillosis

The Aspergillus Website - articles — Tue, 22 Nov 2011 17:25:46 +0100

Zhang S, Corapi W, Quist E, Griffin S, Zhang M (Source: The Aspergillus Website - articles)

Posaconazole prophylaxis during front-line chemotherapy of acute myeloid leukemia: a single center real life experience.

Haematologica — Fri, 18 Nov 2011 05:00:00 +0100

Conclusions. Posaconazole primary antifungal prophylaxis during front-line chemotherapy was effective in preventing invasive fungal diseases in a 'real life' scenario of acute myeloid leukemia patients, resulted in an early but transitory survival advantage in younger patients and was associated to economical advantages. PMID: 22102706 [PubMed - as supplied by publisher] (Source: Haematologica)

[Invasive aspergillosis with extrapulmonary involvement: pathogenesis, clinical characteristics and prognosis.]

Revista Iberoamericana de Micologia — Fri, 18 Nov 2011 05:00:00 +0100

CONCLUSIONS: Invasive aspergillosis with extrapulmonary involvement is rare. The most common presentation is invasive sinusistis which has a lower mortality. Other clinical forms with extrapulmonary involvement were associated with severe immunosuppression or previous surgery, and had a poor outcome. PMID: 22108606 [PubMed - as supplied by publisher] (Source: Revista Iberoamericana de Micologia)

An unusual case of hoarseness of voice related to corticosteroid treatment

Respiratory Medicine CME — Thu, 17 Nov 2011 12:48:12 +0100

This report describes the case of a 56-year-old lady with Chronic Obstructive Pulmonary Disease receiving long-term inhaled corticosteroids who presented with a four-week history of progressive hoarseness, dyspnoea and cough. Sputum cultures at the time isolated Aspergillus fumigatus. She was commenced on a trial of Itraconazole for presumed Allergic Bronchopulmonary Aspergillosis. Due to the duration and nature of her symptoms, vocal cord biopsies were taken which revealed abundant colonies of the fungus A. fumigatus infiltrating skeletal muscle. Inhaled corticosteroids were discontinued and the patient was switched to voriconazole. She continues to make a protracted recovery and is being closely monitored. (Source: Respiratory Medicine CME)

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Allergic bronchopulmonary aspergillosis presenting with cough variant asthma with spontaneous remission

Respiratory Medicine CME — Thu, 17 Nov 2011 12:48:12 +0100

Abstract: A 60-year-old woman presented with a dry cough without dyspnea or wheezing. Chest CT showed an image of mucoid impactions, which were identified as mucoid impactions by bronchofiberscopy. Aspergillus niger was cultured from her mucus. Her serum total IgE was 5150 IU/ml. Precipitins and IgE specific for Aspergillus were positive. She had no history of asthma and no evidence of bronchoconstriction by pulmonary function tests. Thus, a diagnosis was made of allergic bronchopulmonary aspergillosis without asthma. She refused to take oral corticosteroids, although she improved spontaneously. However, her dry cough persisted. Her cough was relieved by administering an inhaled β-2 agonist; therefore, cough variant asthma was diagnosed. She was treated with an inhaled corticosteroid and...

Misleading chest radiograph in a case of allergic bronchopulmonary aspergillosis

Respiratory Medicine CME — Thu, 17 Nov 2011 12:48:12 +0100

We present a case of apparent convincing bilateral hilar lymphadenopathy on a chest radiograph, which on further investigation was found to be allergic bronchopulmonary aspergillosis with symmetrical bilateral apical lower lobe infiltrates. This case demonstrates the role of three-dimensional imaging for disorders of the hila and mediastinum, which are poorly delineated on plain radiography. (Source: Respiratory Medicine CME)

Iliopsoas abscess caused by Aspergillus fumigatus complicated by pulmonary aspergillosis

Journal of Infection and Chemotherapy — Mon, 14 Nov 2011 06:35:13 +0100

We report a case of iliopsoas abscess caused by Aspergillus fumigatus with pulmonary complications. A 60-year-old man was admitted to the Showa University Hospital Department of Gastroenterology with fulminant hepatitis B on April 14, 2010, and treated with steroids. Although fulminant hepatitis B was improved by steroid and symptomatic therapy, he developed a fever on hospital day 39. The chest X-ray film showed a nodular lesion in the right middle-lower lung field, and both the (1 → 3)-β-d-glucan and Candida mannan antigen tests were positive. The β-d-glucan level increased despite treatment with fluconazole and other drugs, including low-dose micafungin. Abdominal computed tomography showed a low-density area in the right iliopsoas muscle. He was then referred to the D...

Invasive pulmonary aspergillosis in an immunocompetent patient

Respiratory Medicine CME — Sun, 13 Nov 2011 21:28:38 +0100

We report a case of an immunocompetent patient who developed fatal pneumonia secondary to Aspergillus fumigatus. (Source: Respiratory Medicine CME)

Aspergillus fumigatus Densities in Relation to Forest Succession and Edge Effects: Implications for Wildlife Health in Modified Environments

EcoHealth — Fri, 11 Nov 2011 06:55:09 +0100

We report that the prevalence of A. fumigatus spores in the soil is much higher in young growth forests and forest edge habitats. Results suggest that hihi mortality rates between islands are potentially due to differential exposure to A. fumigatus spores. We assess relationships between habitat disturbance, A. fumigatus contamination and hihi mortality rates by testing the following predictions: (1) that densities of A. fumigatus spores will be higher on modified islands, (2) that densities of A. fumigatus spores on islands will be correlated with hihi mortality rates and (3) that densities of A. fumigatus spores will be higher at the forest edge than in the interior. We test each of these predictions using soil samples, air samples and samples of nectar from plant species fed on by hih...

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Molecular Diagnosis and Species-specific Identification of Medically Important Aspergillus species by Real Time PCR in Experimental Invasive Pulmonary Aspergillosis

The Aspergillus Website - articles — Thu, 10 Nov 2011 20:47:54 +0100

Walsh TJ, Wissel MC, Grantham KJ, Petraitiene R, Petraitis V, Kasai M, Francesconi A, Cotton MP, Hughes JE, Greene L, Bacher JD, Manna P, Salomoni M, Kleiboeker SB, Reddy SK (Source: The Aspergillus Website - articles)

Population Pharmacokinetics of Voriconazole in Adults.

Antimicrobial Agents and Chemotherapy — Mon, 07 Nov 2011 05:00:00 +0100

Authors: Hope WW Abstract Voriconazole is a first-line agent for the treatment of invasive fungal infections. The pharmacology of voriconazole is characterized by extensive inter-individual variability and nonlinear pharmacokinetics. The population pharmacokinetics of voriconazole in 64 adults are described. The patient population consisted of 21 healthy volunteers who received a range of i.v. and oral voriconazole regimens, and 43 patients with proven or probable invasive aspergillosis, who received the currently licensed dosage. Voriconazole concentrations were measured using HPLC. The pharmacokinetic data were modeled using a nonparametric methodology and with a nonlinear pharmacokinetic structural model. The extent and consequences of pharmacokinetic variability were explored u...

Immunopathology and immunogenetics of allergic bronchopulmonary aspergillosis

The Aspergillus Website - articles — Thu, 03 Nov 2011 20:29:12 +0100

Knutsen AP (Source: The Aspergillus Website - articles)

Chondrolysis of the Tibial Plateau Caused by Articular Aspergillosis After ACL Autograft Reconstruction: Management with a Fresh Osteochondral Allograft: A Case Report.

The Journal of Bone and Joint Surgery. American volume — Wed, 02 Nov 2011 04:00:00 +0100

Authors: Antkowiak TT, Polage CR, Wiedeman JA, Meehan JP, Jamali AA PMID: 22048103 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Primary cutaneous aspergillosis in a patient with systemic lupus erythematosus

Mycoses — Tue, 01 Nov 2011 04:00:00 +0100

(Source: Mycoses)

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Clinical relevance of peripheral blood eosinophil count in allergic bronchopulmonary aspergillosis

Journal of Infection and Public Health — Tue, 01 Nov 2011 04:00:00 +0100

This study was a retrospective analysis of the data from ABPA patients who were managed in our chest clinic. Based on their eosinophil count, the patients were classified into the following three categories: 1000cells/μl. The spirometric, immunological and radiological characteristics were also assessed.Results: We studied 108 males and 101 females with a combined mean (±SD) age of 34.1±12.5years. The median (IQR) eosinophil count at diagnosis was 850 (510–1541)cells/μl, and 60% of the patients had an eosinophil count of (Source: Journal of Infection and Public Health)

Galactomannan detection in bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in patients with hematological diseases—the role of factors affecting assay performance

International Journal of Infectious Diseases — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions: In contrast to recently published data, we found only moderate sensitivity, but high specificity and high positive predictive value of the detection of GM in BAL fluid. In addition, neutropenia, antifungal therapy, and BAL standardization affected GM assay performance. (Source: International Journal of Infectious Diseases)

Orbital Apergillosis Treated with Retrobulbar Amphotericin B.

Orbit — Wed, 26 Oct 2011 04:00:00 +0100

Authors: Mainville N, Jordan DR Abstract A 61-year-old male underwent a cardiac transplant for congenital dilated cardiomyopathy. Two months post-transplantation, after a complicated clinical course, he was noted to have progressive proptosis and limitation of motility OD. Computed tomography showed opacification of the right maxillary sinus with the suggestion of a fungus ball and soft tissue infiltration along the floor of the orbit adjacent to the inferior rectus, extending posteriorly to within millimeters of the superior and inferior orbital fissures. An orbital biopsy demonstrated the presence of fungal hyphae and A. fumigatus was cultured. The patient was treated with systemic antifungal therapy and intralesional retrobulbar amphotericin B (without debridement) with successf...

Oligopeptide transport and regulation of extracellular proteolysis are required for growth of Aspergillus fumigatus on complex substrates but not for virulence

Molecular Microbiology — Mon, 24 Oct 2011 04:00:00 +0100

SummaryMoulds are characterized by their saprophytic lifestyle that is based on osmotrophy. Among them, Aspergillus fumigatus has emerged as the leading cause of fungal infections in the presence of an underlying immunodeficiency. To assess the role of its nutritional versatility for virulence, transcriptional profiling studies in the presence of varying sources of nitrogen were carried out and revealed an extensive reprogramming of the fungal transcriptome when shifting to a proteinaceous growth substrate. Transcripts encoding metabolic activities were predominantly upregulated, as were proteinases and transport activities. To probe whether fundamental aspects of its osmotrophic lifestyle, that is, extracellular proteolysis and uptake of oligopeptides, are required for A. fumigatus path...

Early diagnosis of candidemia in intensive care unit patients with sepsis: a prospective comparison of (1->3)-beta-D-glucan assay, Candida score, and colonization index

Critical Care — Sat, 22 Oct 2011 04:00:00 +0100

Conclusions: A single-point BG assay based on a blood sample drawn at the sepsis onset, alone or in combination with Candida score, may guide the decision to start antifungal therapy early in patients at risk for Candida infection. (Source: Critical Care)

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Antifungal activity of phenolic-rich Lavandula multifida L. essential oil

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 21 Oct 2011 16:01:31 +0100

This study evaluates the antifungal activity and mechanism of action of a new chemotype of Lavandula multifida from Portugal. The essential oil was analyzed by gas chromatography (GC) and gas chromatography/mass spectrometry (GC/MS), and the minimal inhibitory concentration (MIC) and minimal lethal concentration (MLC) of the oil and its major compounds were determined against several pathogenic fungi responsible for candidosis, meningitis, dermatophytosis, and aspergillosis. The influence of the oil on the dimorphic transition in Candida albicans was also studied, as well as propidium iodide (PI) and FUN-1 staining of C. albicans cells by flow cytometry. The essential oil was characterized by high contents of monoterpenes, with carvacrol and cis-β-ocimene being the main constituents. T...

Cutaneous aspergillosis in a heart-transplant patient

Indian Journal of Dermatology, Venereology and Leprology — Fri, 21 Oct 2011 04:00:00 +0100

Ana Brinca, David Serra, Maria M Brites, Óscar Tellechea, Américo FigueiredoIndian Journal of Dermatology, Venereology, and Leprology 2011 77(6):719-721 (Source: Indian Journal of Dermatology, Venereology and Leprology)

Successful allogeneic hematopoietic stem cell transplantation for chronic granulomatous disease with inflammatory complications and severe infection.

International Journal of Hematology — Fri, 21 Oct 2011 04:00:00 +0100

We report two patients with chronic granulomatous disease (CGD). The first patient presented with granulomatous colitis and pulmonary aspergillosis, and the second patient with liver abscess and restrictive pulmonary disorder. Both patients underwent allogeneic hematopoietic stem cell transplantation, the first from an HLA-matched sibling donor, and the second from an HLA-matched unrelated donor, after preconditioning with fludarabine, anti-thymocyte globulin, cyclophosphamide, and total-body irradiation of 3 Gy. The engraftment was prompt and the regimen-related toxicity was mild. The patients are able to return to their daily lives with full donor chimerism, although the second patient underwent a living-related-donor orthotopic liver transplantation from his mother for chronic liver gr...

Reversed halo sign: high-resolution CT findings in 79 patients.

Chest — Thu, 20 Oct 2011 04:00:00 +0100

Authors: Marchiori E, Zanetti G, Escuissato DL, Souza AS, Meirelles GD, Fagundes J, Souza CA, Hochhegger B, Marom EM, Godoy MB Abstract AbstractThe purpose of this study was to evaluate the high-resolution computed tomography (HRCT) findings of patients with the reversed halo sign (RHS) and to identify distinguishing features among the various etiologies. Two chest radiologists reviewed the high-resolution CT scans of 79 patients with RHS and determined CT findings by consensus. We studied the morphological characteristics, number of lesions, and presence of features associated with RHS. Forty patients presented with infectious diseases (paracoccidioidomycosis, tuberculosis, zygomycosis, invasive pulmonary aspergillosis, Pneumocystis jiroveci pneumonia, histoplasmosis, cryptococcos...

Fatal pandemic influenza A/H1N1 infection complicated by probable invasive pulmonary aspergillosis

Mycoses — Wed, 19 Oct 2011 07:40:57 +0100

(Source: Mycoses)

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Outcomes of mechanically ventilated hematology patients with invasive pulmonary aspergillosis

The Aspergillus Website - articles — Tue, 18 Oct 2011 19:49:14 +0100

Burghi G, Lemiale V, Seguin A, Lambert J, Lacroix C, Canet E, Moreau AS, Ribaud P, Schnell D, Mariotte E, Schlemmer B, Azoulay E (Source: The Aspergillus Website - articles)

Invasive Mucormycosis and Aspergillosis in a Healthy 22-Year-Old Battle Casualty: Case Report

Surgical Infections — Tue, 18 Oct 2011 03:12:24 +0100

Surgical Infections , Vol. 0, No. 0. (Source: Surgical Infections)

Link between CFTR mutations and ABPA: a systematic review and meta‐analysis

Mycoses — Mon, 17 Oct 2011 04:00:00 +0100

Summary There is a biological plausibility on the link between cystic fibrosis transmembrane conductance regulator (CFTR) mutations and allergic bronchopulmonary aspergillosis (ABPA). The aim of the systematic review was to investigate this link by determining the frequency of CFTR mutations in ABPA. We searched the PubMed and EmBase databases for studies reporting CFTR mutations in ABPA. We pooled the odds ratio (OR) and 95% confidence intervals (CI) from individual studies using both fixed and random effects model. Statistical heterogeneity was evaluated using the I2 test and the Cochran‐Q statistic. Publication bias was assessed using both graphical and statistical methods. Our search yielded four studies (79 ABPA, 268 controls). The odds of encountering CFTR mutation was higher in...

Necrotizing pulmonary aspergillosis caused by anorexic syndrome — a case report

Central European Journal of Medicine — Sat, 15 Oct 2011 05:52:17 +0100

Abstract The patient presented is a 44-year-old female treated for cavitary changes in the lung apexes. Due to suspected tuberculosis, treatment began with anti-tuberculosis (AT) drugs, despite negative sputum smears for acid-fast bacilli. During hospitalization, the patient was febrile (up to 38°C), hypotensive, extremely cachectic (32 kg), had a dry cough, increased nitrogen products, hypokalemia and anemia. Because of poor response to the applied AT therapy, bronchoscopic tests were repeated and spores of aspergillus fungus were discovered in the pathohistological findings of transbronchial lung biopsy. The appropriate treatment with amphotericin B and voriconazole was initiated. A psychiatric opinion was requested because we suspected that the patient suffered from th...

Culture-positive invasive aspergillosis in a medical center in Taiwan, 2000–2009

European Journal of Clinical Microbiology and Infectious Diseases — Thu, 13 Oct 2011 15:46:57 +0100

In conclusion, autoimmune disorders and underlying pulmonary diseases should also be considered as important predisposing factors of IA. Further emphasis on surgery and voriconazole in the management of IA might be beneficial. Content Type Journal ArticleCategory ArticlePages 1-8DOI 10.1007/s10096-011-1445-1Authors H.-C. Hsiue, School of Medicine, National Taiwan University College of Medicine, Taipei, TaiwanT.-H. Wu, School of Medicine, National Taiwan University College of Medicine, Taipei, TaiwanT.-C. Chang, Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, TaiwanY.-C. Hsiue, School of Medicine, National Taiwan University College of Medicine, Taipei, TaiwanY.-T. Huang, Departments of Laboratory Medicine and I...

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Methylprednisolone/mycophenolate mofetil/tacrolimus: Invasive pulmonary aspergillosis in a liver transplant recipient: case report

Reactions — Wed, 12 Oct 2011 06:03:59 +0100

(Source: Reactions)

Vfend combination therapy shows positive results: Pfizer study

Pharmaceutical Technology — Thu, 06 Oct 2011 18:01:14 +0100

Pfizer has reported the top-line results of a prospective Phase III, double-blind clinical trial which compared the combination of Vfend (voriconazole) and Eraxis (anidulafungin) to Vfend monotherapy for primary therapy of invasive aspergillosis (IA)…Post to:Delicious Digg reddit Facebook StumbleUpon (Source: Pharmaceutical Technology)

Efficacy and Safety of Current Drug Therapies for Invasive Aspergillosis

Karger Publishers — Wed, 05 Oct 2011 23:00:00 +0100

Pharmacology 2011;88:213–224 (DOI:10.1159/000331860) (Source: Karger Publishers)

An observational efficacy and safety analysis of the treatment of acute invasive aspergillosis using voriconazole

European Journal of Clinical Microbiology and Infectious Diseases — Wed, 05 Oct 2011 05:47:56 +0100

Abstract The purpose of this study was to evaluate efficacy and safety of voriconazole in patients with acute invasive aspergillosis (IA) in a real-life, clinical setting. This was a multicenter observational study in adult patients treated with voriconazole for invasive mycosis. The study evaluated clinical response, mortality, use of other licensed antifungal therapy (OLAT), and treatment duration. This sub-analysis evaluated treatment and outcome data specifically from adult patients with proven/probable IA, while safety data were assessed in patients with proven/probable/possible IA. Of the 141 patients enrolled, 113 were adults with proven/probable IA and six had possible IA. Voriconazole treatment duration ranged from 1 to 183 days (median, 49.5 days). Vori...

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Pulmonary aspergillosis in non-immunocompromised patient with acute respiratory distress syndrome during A (H1N1) infection.

Annales Francaises d'Anesthesie et de Reanimation — Tue, 04 Oct 2011 04:00:00 +0100

Authors: Passouant O, Mateu P, Commandini M, Brenkle K, Just B PMID: 21978476 [PubMed - as supplied by publisher] (Source: Annales Francaises d'Anesthesie et de Reanimation)

Differences in Efficacy and Cytokine Profiles following Echinocandin or Liposomal Amphotericin B Monotherapy or Combination Therapy for Murine Pulmonary or Systemic Aspergillus flavus Infections.

Antimicrobial Agents and Chemotherapy — Mon, 03 Oct 2011 04:00:00 +0100

Authors: Olson JA, Schwartz J, Hahka D, George A, Proffitt RT, Adler-Moore JP Abstract Given the recent increase in non-fumigatus aspergillosis, micafungin, caspofungin, and liposomal amphotericin B (L-AmBi) were investigated as monotherapy or combination therapy for murine systemic or pulmonary Aspergillus flavus infection. Treatment for 3 or 6 days was begun 24h (i.v., 2.8 X 10(4) conidia) or 2h (intranasal, 4.1-6.75 X 10(6) conidia) post-challenge as follows: 5 or 10 mg/kg L-AmBi, 10 mg/kg caspofungin, 15 mg/kg micafungin, L-AmBi plus echinocandin, L-AmBi d1-3/echinocandin d4-6, echinocandin d1-3/L-AmBi d4-6. Mice were monitored for survival, fungal burden, serum or tissue cytokines and lung histopathology. In the systemic infection, micafungin or caspofungin was more effective ...

Allergic bronchopulmonary aspergillosis: a reversible cause of complete lung collapse

Internal Medicine Journal — Sat, 01 Oct 2011 04:00:00 +0100

(Source: Internal Medicine Journal)

Clinical Implications of Azole Resistance in Aspergillus fumigatus, the Netherlands, 2007-2009.

Emerging Infectious Diseases — Sat, 01 Oct 2011 04:00:00 +0100

Authors: van der Linden JW, Snelders E, Kampinga GA, Rijnders BJ, Mattsson E, Debets-Ossenkopp YJ, Kuijper EJ, Van Tiel FH, Melchers WJ, Verweij PE Abstract The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%-9.5%). Patients with a hematologic or oncologic disea...

Diffuse infiltration of Aspergillus hyphae in the thyroid gland with multinodular goiter.

Indian Journal of Pathology and Microbiology — Sat, 01 Oct 2011 04:00:00 +0100

We report a case of Aspergillosis of the thyroid of a patient who underwent surgery for a multinodular goiter. PMID: 22234119 [PubMed - in process] (Source: Indian Journal of Pathology and Microbiology)

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Invasive fungal infections following liver transplantation - risk factors, incidence and outcome.

Annals of Transplantation — Fri, 30 Sep 2011 04:00:00 +0100

Conclusions: Early diagnosis and prompt treatment is fundamental for patient survival.<br /> PMID: 21959504 [PubMed - as supplied by publisher] (Source: Annals of Transplantation)

New category of probable invasive pulmonary aspergillosis in hematologic patients

Clinical Microbiology and Infection — Tue, 27 Sep 2011 04:00:00 +0100

AbstractThe European Organization for Research and Treatment of Cancer and the Mycosis Study Group (EORTC‐MSG) radiological definitions of invasive pulmonary aspergillosis (IPA) may lack diagnostic sensitivity. We evaluated the hypothesis to apply less restrictive radiological criteria, when supported by specific microbiological findings, to define IPA in acute myeloid leukemia (AML), lymphoprolipherative diseases (LD) and allogeneic stem cell transplant (allo‐SCT) patients. Overall, 109 consecutive episodes of proven/probable IPA in 56 AML, 31 LD and 22 allo‐SCT patients diagnosed from February 2006 through January 2011 were considered. IPA was diagnosed with EORTC‐MSG criteria (control group, 76 patients) or without prespecified radiologic criteria (study group, 33 patients). The...

New category of probable invasive pulmonary aspergillosis in haematological patients

Clinical Microbiology and Infection — Tue, 27 Sep 2011 04:00:00 +0100

Clin Microbiol Infect 2011AbstractThe European Organization for Research and Treatment of Cancer and the Mycosis Study Group (EORTC‐MSG) radiological definitions of invasive pulmonary aspergillosis (IPA) may lack diagnostic sensitivity. We evaluated applying less restrictive radiological criteria, when supported by specific microbiological findings, to define IPA in acute myeloid leukaemia (AML), lymphoproliferative diseases (LD) and allogeneic stem cell transplant (allo‐SCT) patients. Overall, 109 consecutive episodes of proven/probable IPA in 56 AML, 31 LD and 22 allo‐SCT patients diagnosed from February 2006 through to January 2011 were considered. IPA was diagnosed with EORTC‐MSG criteria (control group, 76 patients) or without prespecified radiological criteria (study group, 3...

Current Role of Echinocandins in the Management of Invasive Aspergillosis

Current Infectious Disease Reports — Sat, 24 Sep 2011 15:44:18 +0100

Abstract Echinocandins are parenteral antifungals with a unique site of action targeting the cell wall synthesis. There are three molecules available, anidulafungin, caspofungin, and micafungin, which have fungicidal and fungistatic activity against Candida and Aspergillus, respectively, and an excellent safety profile. There is consistent proof of clinical activity against Aspergillus for caspofungin, while less is known for micafungin and even lees for anidulafungin. Micafungin and caspofungin have been successfully used in targeted treatment of aspergillosis, prophylaxis, and empirical therapy, both as monotherapy and in combination with other antifungals. Caspofungin is approved for empirical therapy of febrile neutropenia and salvage treatment of invasive aspergillosis,...

Assessment of efficacy of antifungals in experimental models of invasive aspergillosis in an era of emerging resistance: the value of real-time quantitative PCR

The Aspergillus Website - articles — Thu, 22 Sep 2011 18:37:50 +0100

Seyedmousavi S, Melchers WJ, Verweij PE, Mouton JW (Source: The Aspergillus Website - articles)

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The economic impact of aspergillosis: analysis of hospital expenditures across patient subgroups

The Aspergillus Website - articles — Wed, 21 Sep 2011 22:05:52 +0100

Tong KB, Lau CJ, Murtagh K, Layton AJ, Seifeldin R (Source: The Aspergillus Website - articles)

Histological Aspects of the Pathogenesis of Some Opportunistic Fungal Infections, as Exemplified in the Pathology of Aspergillosis and the Phycomycetoses

The Aspergillus Website - articles — Wed, 21 Sep 2011 18:38:04 +0100

William St. Clair Symmers, MD (Source: The Aspergillus Website - articles)

In vitro activity of isavuconazole against 208 Aspergillus flavus isolates in comparison with 7 other antifungal agents: assessment according to the methodology of the European Committee on Antimicrobial Susceptibility Testing

Diagnostic Microbiology and Infectious Disease — Wed, 21 Sep 2011 04:00:00 +0100

Abstract: Aspergillus flavus is the second most common species causing invasive aspergillosis after A. fumigatus. In certain countries like India, Sudan, and Saudi Arabia, A. flavus is most frequently isolated from patients with fungal rhinosinusitis and endophthalmitis. A. flavus exhibit an increased resistance to antifungal agents compared to A. fumigatus. We determined the in vitro activity of isavuconazole, voriconazole, posaconazole, itraconazole, amphotericin B, caspofungin, micafungin, and anidulafungin against 208 isolates of A. flavus by the EUCAST method and compared with the results obtained by the CLSI method. Isavuconazole and voriconazole MICs were ≤2 μg/mL in 99% and 95%, respectively. Posaconazole and itraconazole MICs were ≤0.5 and ≤1 μg/mL, respectively, for all i...

Immunotherapy of aspergillosis

Clinical Microbiology and Infection — Tue, 20 Sep 2011 04:00:00 +0100

AbstractManagement of invasive aspergillosis in high risk patients remains a challenging effort. There is an increasing demand for novel therapeutic strategies aiming at enhancing or restoring antifungal immunity in immunocompromised patients. In this regard, modulating specific innate immune functions and vaccination are promising immunotherapeutic strategies. Recent findings have also provided a compelling rationale to assess the contribution of the individual genetic profile to the immunotherapy outcome. Altogether, integrating immunologic and genetic data may contribute to the optimization of therapeutic strategies exerting control over immune pathways, ultimately improving the management of fungal infections in high risk settings. (Source: Clinical Microbiology and Infection)

Azole Antifungal Resistance Today: Focus on Aspergillus

Current Infectious Disease Reports — Mon, 19 Sep 2011 15:40:36 +0100

Abstract Oral triazole therapy is well established for the treatment of invasive aspergillosis (IPA), allergic aspergillosis (ABPA), and chronic pulmonary aspergillosis (CPA), and is often long-term. Resistance to triazole azole antifungal drugs in Aspergillus fumigatus is now a major clinical problem in a number of European locations, in China, Canada and the USA with particularly high frequencies from the north-west of the UK, and The Netherlands. A number of centers are reporting the continuing increasing frequency and evolution of resistance mechanisms in A. fumigatus, in both azole-naïve and patients treated with azoles. The increasing rate of resistance is of concern. A number of resistance mechanisms have been found. The biofilm modality of Aspergillus growth may hav...

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Overview of safety experience with caspofungin in clinical trials conducted over the first 15 years: a brief report

International Journal of Antimicrobial Agents — Mon, 19 Sep 2011 04:00:00 +0100

In conclusion, CAS has demonstrated a favourable safety profile in 1951 adult and paediatric patients enrolled in clinical trials. (Source: International Journal of Antimicrobial Agents)

Cyclophosphamide/fludarabine: Aspergillosis: case report

Reactions — Sun, 18 Sep 2011 23:35:47 +0100

(Source: Reactions)

Global population structure of Aspergillus terreus inferred by ISSR typing reveals geographical subclustering

BMC Microbiology - Latest articles — Fri, 16 Sep 2011 04:00:00 +0100

Conclusions: This study provides evidence of a population structure linked to geographical origin in A. terreus. (Source: BMC Microbiology - Latest articles)

Aspergillosis case-fatality rate: systematic review of the literature

The Aspergillus Website - articles — Thu, 15 Sep 2011 14:58:13 +0100

Lin SJ, Schranz J, Teutsch SM (Source: The Aspergillus Website - articles)

Corticosteroids in Respiratory Diseases in Children.

American Journal of Respiratory and Critical Care Medicine — Thu, 15 Sep 2011 04:00:00 +0100

Authors: de Benedictis FM, Bush A Abstract We review recent advances in the use of corticosteroids in pediatric lung disease. They are frequently used, either systemically or by inhalation. Their mechanisms of action in pulmonary diseases are ill defined. Corticosteroids exert direct inhibitory effects on many inflammatory cells through genomic mechanisms. There is a time lag before clinical response, and the wash out of effects is also prolonged. Prompt relief in some conditions such as croup may be related to airway mucosal vasoconstriction through a nongenomic mechanism. Corticosteroids have proven beneficial roles in asthma, croup, allergic bronchopulmonary aspergillosis and subglottic hemangioma. In some conditions, such as bronchiolitis, cystic fibrosis and bronchopulmonary d...

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Chronic pulmonary aspergillosis

The Aspergillus Website - articles — Tue, 13 Sep 2011 11:41:09 +0100

Tsuji S, Ogawa K (Source: The Aspergillus Website - articles)

Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis among asthma patients in eastern India

The Aspergillus Website - articles — Tue, 13 Sep 2011 11:41:09 +0100

Ghosh T, Dey A, Biswas D, Chatterjee S, Haldar N, Maiti PK (Source: The Aspergillus Website - articles)

A phase II dose escalation study of caspofungin for invasive aspergillosis.

Antimicrobial Agents and Chemotherapy — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions. In first-line treatment of invasive aspergillosis, daily doses of up to 200 mg caspofungin were well-tolerated and maximum tolerated dose was not reached. Pharmacokinetics was linear. Response rates were similar to those previously reported for voriconazole and liposomal amphotericin. PMID: 21911573 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Synergistic interaction of the triple combination of amphotericin B, ciprofloxacin and polymorphonuclear neutrophils against Aspergillus fumigatus.

Antimicrobial Agents and Chemotherapy — Mon, 12 Sep 2011 04:00:00 +0100

Authors: Stergiopoulou T, Meletiadis J, Seiin T, Papaioannidou P, Walsh TJ, Roilides E Abstract Aspergillus is damaged by polymorphonuclear neutrophils by use of non-oxidative and oxidative mechanisms, which may be affected by antifungal and antibacterial agents that patients with invasive pulmonary aspergillosis often receive. The pharmacodynamic interactions among deoxycholate amphotericin B (AMB), ciprofloxacin (CIP) and human polymorphonuclear neutrophils (PMNs) against Aspergillus fumigatus growth are unknown. We therefore studied the interactions between 0.032-2.0 μg/ml of AMB, 0.1-50 μg/ml of CIP at a fixed ratio 1:3 and PMNs from six donors at E:T ratio 400:1 against a clinical A. fumigatus isolate using XTT metabolic assay and analyzed by the Bliss independence pharmacod...

Invasive aspergillosis: an important risk factor on the short- and long-term survival of acute myeloid leukemia (AML) patients

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 09 Sep 2011 16:46:21 +0100

Abstract Invasive aspergillosis (IA) during induction chemotherapy of acute myeloid leukemia (AML) could worsen the prognosis. Our objective was to study how the development of IA during AML interferes with the therapeutic strategy and to evaluate its impact on the short- and long-term survival. Newly diagnosed AML patients between the years 2004 and 2007 were retrospectively analyzed. The outcome was death of the patient. A Cox proportional hazards model with the diagnosis of IA and post-induction response evaluation as the main exposure was fitted. Overall, 262 patients were analyzed and 58 IA were observed. The 2-year survival of patients having had remission of AML was 54% and, for patients with failure of chemotherapy, it was 5% (p < 0.001). The 2-year survival ...

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What Causes Coughs?

PediatricEducation.org — Mon, 05 Sep 2011 00:22:52 +0100

Discussion “A cough is a voluntary or involuntary explosive expiration. After a deep inspiration, the glottis is closed and the expiratory muscles contract, compressing the lung and raising intrapulmonary pressure above the atmospheric pressure. The glottis then opens, and gas is expelled at a rapid rate.” Acute coughs are commonly due to upper respiratory tract diseases in children of all ages – often because of post-nasal rhinorrhea. Chronic coughs may be more difficult to determine the cause of and may require more investigation, consultation, and/or empiric trials of medication including radiographic imaging of chest or sinuses, spirotometry, sweat chloride, methacholine challenge, bronchoscopy, gastroscopy, immunodeficiency testing, etc. Children with congenital abn...

ABPA Concomitantly Occurring with Invasive Sinus Aspergillosis: A Short Report on Two Patients

Indian Journal of Otolaryngology and Head and Neck Surgery — Sun, 04 Sep 2011 10:53:44 +0100

Abstract Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder that is caused by hypersensitivity to Aspergillus fumigatus with resultant systemic immune activation, chronic asthma, recurrent pulmonary infiltrates, and bronchiectasis. First described by Hinson et al. (Thorax 7:317–333 [1]) in 1952, this disease occurs in 1–2% of patients with persistent asthma and in 2–15% of patients with cystic fibrosis (Greenberger, Front Biosci 8:s119–s127 [2]). Although the diagnostic criteria for ABPA have been laid down (and include bronchial asthma, immediate skin test reactivity to A. fumigatus, elevated total serum IgE level, pulmonary infiltrates, central bronchiectasis, peripheral blood eosinophilia, and positive serum precipitins [IgG] against Aspergillu...

Assessment of efficacy of antifungals in experimental models of invasive aspergillosis in an era of emerging resistance: the value of real-time quantitative PCR.

Current Opinion in Pharmacology — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Seyedmousavi S, Melchers WJ, Verweij PE, Mouton JW Abstract Experimental models of invasive aspergillosis (IA) have been used to explore pharmacokinetic and pharmacodynamic (PK/PD) properties of antifungal agents. Survival is still considered the golden standard effect measure but has the disadvantage that a large number of animals are needed to determine the dose-response relationships and PK/PD of antifungals. The feasibility of using fungal load by real-time quantitative PCR (qPCR) as an effect measure has been explored recently. The majority of studies reported convincingly demonstrate a larger dynamic range for qPCR compared to conventional assays. However interpretation and translating the results to guidance in clinical decision making need further study. It is expe...

Immunity and tolerance to infections in experimental hematopoietic transplantation

Best Practice and Research. Clinical Haematology — Thu, 01 Sep 2011 04:00:00 +0100

Resistance and tolerance are two types of host defense mechanisms that increase fitness in response to fungi. Several genetic polymorphisms in pattern recognition receptors, most remarkably Toll-like receptors (TLRs), have been described to influence resistance and tolerance to aspergillosis in distinct clinical settings. TLRs on dendritic cells pivotally contribute in determining the balance between immunopathology and protective immunity to the fungus. Epithelial cells also contribute to this balance via selected TLRs converging on indoleamine-2,3-dioxygenase (IDO). Studies in experimental hematopoietic transplantation confirmed the dichotomy of pathways leading to resistance and tolerance to the fungus providing new insights on the relative contribution of the hematopoietic/nonhematopoi...

Invasive fungal infections in onco-haematology: a Spanish perspective.

Revista Espanola de Quimioterapia — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Abstract Data provided by this survey carried out in a representative sample of 27 Spanish haematologists on current and crucial aspects of the treatment of fungal infection in the haematological patient, can be summarized as follows: 1)The efficacy of antifungal drugs against filamentous fungi is very important in the choice of empirical treatment for more than half of the specialists surveyed, particularly in case of aspergillosis. 2)The type of activity of the antifungal drug (fungicidal or fungistatic) is also considered by more than half of haematologists at the time of treating infections by filamentous fungi. 3)Voriconazole and liposomal amphotericin B are consideraded by almost all haematologists as the reference antifungal agents for the treatment of aspergillosi...

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The Challenge of Invasive Aspergillosis: Increasing Numbers in Diverse Patient Groups

The Aspergillus Website - articles — Tue, 30 Aug 2011 10:15:32 +0100

Verweij PE, Denning DW (Source: The Aspergillus Website - articles)

Invasive Aspergillosis Complicating Pandemic Influenza A (H1N1) Infection in Severely Immunocompromised Patients

The Aspergillus Website - articles — Tue, 30 Aug 2011 10:12:10 +0100

Garcia-Vidal C, Barba P, Arnan M, Moreno A, Ruiz-Camps I, Gudiol C, Ayats J, Ortí G, Carratalà J (Source: The Aspergillus Website - articles)

Carboplatin/pemetrexed: Febrile neutropenia, aspergillosis, sepsis and death: case report

Reactions — Mon, 29 Aug 2011 14:09:06 +0100

(Source: Reactions)

Primary Aspergillosis of the Larynx: A Case Report

Indian Journal of Otolaryngology and Head and Neck Surgery — Sat, 27 Aug 2011 15:46:41 +0100

Abstract Aspergillosis of larynx is very rare. Only a few cases have been reported in medical literature. Larynx is generally involved secondarily by aspergillosis. Only rarely the larynx happens to be the primary site of involvement. The lesions may be confined to the vocal folds or may involve various other sites of the larynx. There is, invariably, certain risk factors which may predispose for fungal infection like immune deficiency condition, use of inhaled or systemic steroids, long and continuous use of antibiotics etc. These lesions may mimic malignancy or a premalignant condition. Awareness of this entity is essential as the management depends on accurate diagnosis. These lesions invariably respond well to antifungal therapy with elimination of risk factors. Here w...

Outcomes of mechanically ventilated hematology patients with invasive pulmonary aspergillosis

Intensive Care Medicine — Wed, 24 Aug 2011 16:04:35 +0100

Conclusion Hospital mortality remains high in hematology patients requiring MV with IPA, particularly when concommittant infection occurred. The use of voriconazole improved survival. Content Type Journal ArticleCategory OriginalPages 1-8DOI 10.1007/s00134-011-2344-8Authors Gaston Burghi, AP-HP, Hôpital Saint-Louis, Medical ICU, University Paris-7 Paris-Diderot, UFR de Médecine, 1 avenue Claude Vellefaux, 75010 Paris, FranceVirginie Lemiale, AP-HP, Hôpital Saint-Louis, Medical ICU, University Paris-7 Paris-Diderot, UFR de Médecine, 1 avenue Claude Vellefaux, 75010 Paris, FranceAmélie Seguin, AP-HP, Hôpital Saint-Louis, Medical ICU, University Paris-7 Paris-Diderot, UFR de Médecine, 1 avenue Claude Vellefaux, 75010 Paris, FranceJérôme Lambert, AP-HP, Hôpital...

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CD4 T cells mediate the protective effect of the recombinant Asp f3-based anti-aspergillosis vaccine

The Aspergillus Website - articles — Wed, 24 Aug 2011 12:23:24 +0100

Diaz-Arevalo D, Bagramyan K, Hong TB, Ito JI, Kalkum M (Source: The Aspergillus Website - articles)

Gliotoxin as putative virulence factor and immunotherapeutic target in a cell culture model of cerebral aspergillosis

The Aspergillus Website - articles — Tue, 23 Aug 2011 14:46:20 +0100

Speth C, Kupfahl C, Pfaller K, Hagleitner M, Deutinger M, Würzner R, Mohsenipour I, Lass-Flörl C, Rambach G (Source: The Aspergillus Website - articles)

Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis among asthma patients in eastern India

The Aspergillus Website - articles — Tue, 23 Aug 2011 14:14:51 +0100

Ghosh T, Dey A, Biswas D, Chatterjee S, Haldar N, Maiti PK (Source: The Aspergillus Website - articles)

Investigation of a cluster of cutaneous aspergillosis in a neonatal intensive care unit

The Aspergillus Website - articles — Tue, 23 Aug 2011 12:39:11 +0100

Etienne KA, Subudhi CP, Chadwick PR, Settle P, Moise J, Magill SS, Chiller T, Balajee SA (Source: The Aspergillus Website - articles)

Prevalence of allergic bronchopulmonary aspergillosis in patients with bronchial asthma

The Aspergillus Website - articles — Wed, 17 Aug 2011 14:01:51 +0100

Kumar R, Gaur SN (Source: The Aspergillus Website - articles)

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Allergic bronchopulmonary aspergillosis among asthmatics

The Aspergillus Website - articles — Wed, 17 Aug 2011 13:52:52 +0100

Attapattu MC (Source: The Aspergillus Website - articles)

Long-term follow-up and treatment of congenital alveolar proteinosis

BMC Pediatrics - Latest articles — Tue, 16 Aug 2011 23:00:00 +0100

Conclusions: The long term management from early childhood into young adolescence of severe alveolar proteinosis due to GMCSF receptor deficiency requires a dedicated specialized team to perform technically demanding whole lung lavages and cope with complications. (Source: BMC Pediatrics - Latest articles)

Computed tomography findings in invasive pulmonary aspergillosis in non-neutropenic transplant recipients and neutropenic patients, and their prognostic value

Journal of Infection — Tue, 16 Aug 2011 04:00:00 +0100

Summary: Objectives: We evaluated CT findings and their prognostic value in non-neutropenic transplant recipients with invasive pulmonary aspergillosis (IPA) compared with neutropenic patients with IPA.Methods: All adult patients during a 27-month who met the criteria for proven or probable IPA according to the 2008 EORTC/MSG criteria were retrospectively enrolled. Initial CT findings were reviewed by two radiologists blinded to the patients’ demographics and clinical outcomes.Results: A total of 50 non-neutropenic transplant recipients and 60 neutropenic patients were enrolled. Consolidation-or-mass, halo signs, and angio-invasive form were observed less often in non-neutropenic transplant recipients than in neutropenic patients: (56%, 26%, and 32%) versus (78%, 55%, and 60%, p = 0.01...

A case of pseudomembranous colitis after voriconazole therapy.

Yonsei Medical Journal — Mon, 15 Aug 2011 14:33:25 +0100

Authors: Kwon JC, Kang MK, Kim SH, Choi SM, Kim HJ, Min WS, Lee DG This is a case report on a 35-year-old man with acute myelogenous leukemia who presented fever and intermittent mucoid loose stool to the emergency center. He had been taking voriconazole for invasive pulmonary aspergillosis. The flexible sigmoidoscopy was consistent with the diagnosis of pseudomembranous colitis. PMID: 21786455 [PubMed - in process] (Source: Yonsei Medical Journal)

Invasive aspergillosis arising from ureteral aspergilloma.

Yonsei Medical Journal — Mon, 15 Aug 2011 14:08:19 +0100

We report a case of a 56-year-old man with alcoholic cirrhosis of the liver and diabetes. He had ureteral aspergilloma, discovered as a saprophytic whitish mass. It was treated by ureteroscopic removal, however, he refused antifungal treatment. His condition progressed to invasive aspergillosis, and died from sepsis and hepatorenal syndrome. PMID: 21786456 [PubMed - in process] (Source: Yonsei Medical Journal)

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Saccharomyces as a vaccine against systemic aspergillosis: \'the friend of man\' a friend again?

The Aspergillus Website - articles — Fri, 12 Aug 2011 09:38:01 +0100

Liu M, Capilla J, Johansen ME, Alvarado D, Martinez M, Chen V, Clemons KV, Stevens DA (Source: The Aspergillus Website - articles)

Baker's Yeast Protects Against Fatal Infections

Health News from Medical News Today — Fri, 12 Aug 2011 07:00:00 +0100

Injecting mice with simple baker's yeast protects against the fatal fungal infection, aspergillosis, according to research published in the Journal of Medical Microbiology. The work could lead to the development of a human vaccine that protects immunocompromised people against a range of life-threatening fungal infections, for which current therapy often fails. Researchers from the California Institute for Medical Research, Santa Clara Valley Medical Center and Stanford University gave mice three injections of killed Saccharomyces (baker's yeast), one week apart... (Source: Health News from Medical News Today)

Posaconazole: Lack of efficacy in aspergillosis: case report

Reactions — Wed, 10 Aug 2011 17:36:32 +0100

(Source: Reactions)

Yeast 'may prevent infections'

Nursing in Practice — Wed, 10 Aug 2011 09:31:00 +0100

Yeast could be used to prevent life-threatening fungal diseases such as aspergillosis, scientists claim (Source: Nursing in Practice)

Voriconazole-related severe adverse events: clinical application of therapeutic drug monitoring in Korean patients

International Journal of Infectious Diseases — Wed, 10 Aug 2011 04:00:00 +0100

Conclusions: This study shows that therapeutic drug monitoring is indicated in patients with a voriconazole-related SAE and that dose adjustment is required if the trough concentration of voriconazole exceeds 5.83mg/l. (Source: International Journal of Infectious Diseases)

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Allergic bronchopulmonary aspergillosis in corticosteroid-dependent asthmatics

The Aspergillus Website - articles — Tue, 09 Aug 2011 13:34:57 +0100

Basich JE, Graves TS, Baz MN, Scanlon G, Hoffmann RG, Patterson R, Fink JN (Source: The Aspergillus Website - articles)

The incidence of allergic aspergillosis in chronic asthma

The Aspergillus Website - articles — Tue, 09 Aug 2011 13:31:46 +0100

Agbayani BF, Norman PS, Winkenwerder WL (Source: The Aspergillus Website - articles)

Invasive aspergillosis in patients with hematological malignancies: incidence and description of 127 cases enrolled in a single institution prospective survey from 2004 to 2009

The Aspergillus Website - articles — Tue, 09 Aug 2011 13:08:05 +0100

Nicolle MC, Benet T, Thiebaut A, Bienvenu AL, Voirin N, Duclos A, Sobh M, Cannas G, Thomas X, Nicolini FE, De Monbrison F, Piens MA, Picot S, Michallet M, Vanhems P (Source: The Aspergillus Website - articles)

Baker's yeast protects against fatal infections

EurekAlert! - Infectious and Emerging Diseases — Tue, 09 Aug 2011 04:00:00 +0100

(Society for General Microbiology) Injecting mice with simple baker's yeast protects against the fatal fungal infection, aspergillosis, according to research published in the Journal of Medical Microbiology. The work could lead to the development of a human vaccine that protects immuno-compromised people against a range of life-threatening fungal infections, for which current therapy often fails. (Source: EurekAlert! - Infectious and Emerging Diseases)

Peripheral neuropathy in patients on long-term triazole antifungal therapy

Journal of Antimicrobial Chemotherapy — Mon, 08 Aug 2011 23:00:00 +0100

Conclusions A 10% incidence of PN was observed for patients commenced on triazole therapy for chronic aspergillosis. Patients on long-term triazole therapy should be monitored for neurological symptoms. If PN is suspected, diagnosis should include nerve conduction studies, exclusion of other causes and consideration of dose reduction or cessation of therapy. (Source: Journal of Antimicrobial Chemotherapy)

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The proteomic signature of Aspergillus fumigatus during early development.

Molecular and Cellular Proteomics : MCP — Sun, 07 Aug 2011 23:00:00 +0100

This study provides insights into early pathways activated during growth and development of A. fumigatus. It reveals a pathogen that is gearing up for rapid growth by building translation machinery, generating ATP, and is very much committed to aerobic metabolism. PMID: 21825280 [PubMed - as supplied by publisher] (Source: Molecular and Cellular Proteomics : MCP)

Saccharomyces as a vaccine against systemic aspergillosis: 'the friend of man' a friend again?

Journal of Medical Microbiology — Sun, 07 Aug 2011 23:00:00 +0100

Authors: Liu M, Capilla J, Johansen ME, Alvarado D, Martinez M, Chen V, Clemons KV, Stevens DA Abstract The mortality of clinical Aspergillus infections necessitates consideration of the utility of a vaccine. We have found that Saccharomyces species can act as a protective vaccine against a lethal systemic Aspergillus infection, and describe experiments optimizing a subcutaneous regimen with killed yeast. Three injections of 2.5 mg given a week apart, 2 weeks prior to challenge, consistently, significantly, provided survival protection and reduction of infection in organs in survivors. The protection was independent of the strain of Saccharomyces, and possibly even the species, and could be demonstrated in several inbred (including C'-deficient) and outbred mouse strains. The prote...

In vivo Hypoxia and a Fungal Alcohol Dehydrogenase Influence the Pathogenesis of Invasive Pulmonary Aspergillosis

The Aspergillus Website - articles — Fri, 05 Aug 2011 10:39:27 +0100

Grahl N, Puttikamonkul S, Macdonald JM, Gamcsik MP, Ngo LY, Hohl TM, Cramer RA (Source: The Aspergillus Website - articles)

How I treat mucormycosis

Blood — Wed, 03 Aug 2011 23:00:00 +0100

Unlike invasive aspergillosis, the prognosis and outcome of hematologic malignancy patients who develop invasive mucormycosis have not significantly improved over the past decade as a majority of patients who develop the infection still die 12 weeks after diagnosis. However, early recognition and treatment of invasive mucormycosis syndromes, as well as individualized approaches to treatment and secondary prophylaxis, could improve the odds of survival, even in the most persistently immunosuppressed patient receiving chemotherapy and/or of stem cell transplantation. Herein, we describe the subtle clinical and radiographic clues that should alert the hematologist to the possibility of mucormycosis, and aggressive and timely treatment approaches that may limit the spread of infection before i...

Prospective study in critically ill non-neutropenic patients: diagnostic potential of (1,3)-β-D-glucan assay and circulating galactomannan for the diagnosis of invasive fungal disease

European Journal of Clinical Microbiology and Infectious Diseases — Wed, 03 Aug 2011 05:42:10 +0100

In conclusion, early BG results permit a timely initiation of antifungal therapy in patients at risk of IFD. Content Type Journal ArticlePages 1-11DOI 10.1007/s10096-011-1365-0Authors J. Acosta, Department of Medical Microbiology, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, Madrid, 28041 SpainM. Catalan, Medical Intensive Care Unit, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, Madrid, 28041 SpainA. del Palacio-Pérez-Medel, Department of Internal Medicine, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, Madrid, 28041 SpainJ.-C. Montejo, Medical Intensive Care Unit, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, Madrid, 28041 SpainJ. De-La-Cruz-Bértolo, Clinical Epidemiology Unit, Hospital Universitario 12 de Octubr...

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Eosinophilic pleural effusion with Charcot–Leyden crystals in invasive aspergillosis

Cytopathology — Mon, 01 Aug 2011 23:00:00 +0100

(Source: Cytopathology)

Comparison of an Aspergillus real-time polymerase chain reaction assay with galactomannan testing of bronchoalvelolar lavage fluid for the diagnosis of invasive pulmonary aspergillosis in lung transplant recipients

The Aspergillus Website - articles — Mon, 01 Aug 2011 09:57:19 +0100

Luong ML, Clancy CJ, Vadnerkar A, Kwak EJ, Silveira FP, Wissel MC, Grantham KJ, Shields RK, Crespo M, Pilewski J, Toyoda Y, Kleiboeker SB, Pakstis D, Reddy SK, Walsh TJ, Nguyen MH (Source: The Aspergillus Website - articles)

Combination antifungal therapy for invasive pulmonary aspergillosis in a heart transplant recipient.

Sun, 31 Jul 2011 23:00:00 +0100

We present a 45-year-old male heart transplant recipient who developed fever, progressive worsening of dyspnea, and productive cough without response to antibiotics. Diagnosis of invasive pulmonary aspergillosis was made based on clinical, laboratory, and radiographic findings. The patient was treated successfully with combined antifungal therapy (voriconazole and micafungin). This case report highlights the importance of a high degree of clinical suspicion to allow curative treatment of invasive aspergillosis and the efficiency of new antifungal drugs. PMID: 21819376 [PubMed - in process] (Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation)

Aspergillus fumigatus spondylodiskitis in renal transplant patient: voriconazole experience.

Sun, 31 Jul 2011 23:00:00 +0100

We report a case of aspergillus spondylodiskitis after pulmonary aspergillosis in a renal transplant recipient. He was treated by antifungal therapy and surgical intervention. The transplantist should be alert for a diagnosis of aspergillus spondylodiskitis in recipients who developed back pain after aspergillosis infection in other sites. PMID: 21819372 [PubMed - in process] (Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation)